Future | Homeless group official says he sees an opportunity for all players to work together to make a difference on population’s health

BY ADAM BOWIE DAILY GLEANER BOWIE.ADAM@DAILYGLEANER.COM

The Horizon Health Network will soon release the findings of a health needs assessment that examined Fredericton’s primary health-care system, a process that allowed various community stakeholders to discuss health and wellness issues in the capital region.

In January 2012, the province’s largest regional health authority launched a community health needs assessment for Fredericton and its surrounding areas.

The study was carried out using similar methods as other community needs assessments, but it was determined it should focus on prevention and health, community engagement, and collaborations between local service organizations and leaders from the business community.

Though the report hasn’t been released yet, the Daily Gleaner received a copy of the report’s executive summary from Horizon Health Network.

‘A mixed-methods methodology was used in the assessment, which means both qualitative and quantitative data were collected and analyzed. From this analysis, seven priority populations were profiled: homeless; vulnerably-housed and working poor; First Nations peoples; newcomers (immigrants and refugees); persons with disabilities; rural-urban populations; seniors; and children and youth,’ reads the text of the summary.

‘The data analysis also identified health and wellbeing challenges common among the populations, including the lack of a communication system that sets out what is available and where to find it, no existing simple means of accessing systems and community-based care for persons living with complex needs, inadequate discharge processes for vulnerable populations, and the lack of commitment to make prevention and health a priority.’ The report outlines 10 goals: • centre primary health care on prevention and health; • establish a community health centre in downtown Fredericton; • take health services into Fredericton and surrounding areas and to the people who need them the most; • improve access to information on available community-based and systems-based health and wellbeing services and programs; • leverage Under One Sky Head Start into an urban, off-reserve aboriginal family resource centre; • campaign for a more systematic approach to healthy eating and active living in (the capital region); • provide access to a full spectrum of health services in both official languages; • update the public and health professionals on recent changes to the delivery of mental health and addictions services and engage the public regarding mental resiliency; • identify and collect local data that highlights disparities; • and better connect tertiary and community-based care to facilitate hospital admissions and discharges.

Timothy Ross, co-ordinator of the Commun­ity Action Group on Homelessness, was among the community stakeholders interviewed as part of the study’s public consultation process, even though he doesn’t specifically work in the health-care field. Instead, he was consulted because of his work with some of the city’s most vulnerable populations, who often face health complications after illnesses or injuries go untreated for long periods of time.

He said preventative treatments will help the province save money in the long term.

One of the main ways to avoid those problems is to improve access to primary care services.

‘I think some of the items that were outlined in the assessment were bang-on,’ he said.

‘A particular highlight was looking at the individuals living downtown, who have higher housing costs and lower access to health care and who have a high prevalence of chronic (diseases). What this is indicative of is that importance of affordable housing and ensuring that people can manage their health and wellbeing more effectively.’ Ross said the recent news about the closure of an after-hours clinic on the city’s northside will further strain primary-care access in the city.

He said it’s important that government take action on the community health needs assessment soon after it is officially released.

‘I think this is very timely. The closure of the (Fredericton After-Hours Clinic) leaves folks without access to (regular) health-care in a bind. And there’s a great population in downtown Fredericton still without access to (regular) health care,’ he said, noting that one of the 10 action items listed in the report involves the creation of a community health centre in the downtown area.

‘I really do see an opportunity for all players to work together to really enhance population health…It would be great to see housing and health care come together through the recommendations of this report.’ Ross said he’d like to see government work to improve access to primary care services in co-ordination with an effort to end homelessness through a housing-first philosophy, where anyone who finds themselves homeless is able to get the help they need to find affordable, safe housing.

‘There’s a lot here in the recommendations on how to move forward that parallel the multi-year plans to end homelessness,’ he said.

‘It’s about systems co-ordination, bringing all your resources together, having better metrics, and recognizing the importance of housing-first in population health. Without a safe, decent place to stay, your ability to stay healthy is completely diminished.’ Janet Weber, a nurse practitioner who works with military patients at Canadian Forces Base Gagetown and who was involved with a similar health needs assessment completed for Oromocto and its surrounding areas, said these studies are very specific to the communities, noting that there can be great disparities in the provision of care between two municipalities located so close to each other.

‘One example is that in our assessment we found out, going through statistics, that for women in our catchment, only 52 per cent had a pap test, cervical cancer screening, in the last three years, where in Fredericton it was 84 per cent,’ she said.

‘So that’s one indication that how, sometimes, it can be very specific and the needs can be very different.’ The Horizon Health Network is expected to release the full report in the coming weeks.